Individual provider Active NPI

Kathleen Dodson, LGSW

  • Social Worker
  • Prince Frederick, MD
National Provider Identifier
1619411428
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
975 Solomons Island Rd N
Prince Frederick, MD 20678-3917
Phone
(410) 535-5400
NPI assigned
Dec 13, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X Primary

Addresses

Primary practice location

975 Solomons Island Rd N
Prince Frederick, MD 20678-3917

Mailing address

534 Chisholm TRL
Lusby, MD 20657-3422
Phone (410) 474-3473

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220816003022 MD Practitioner - Clinical Social Worker 4880077387 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Harbor Christian Counseling LLC Social Worker CurrentSince Aug 1, 2022 Accepting new patients
Sondermind Provider Network LLC CurrentSince Oct 25, 2023 Accepting new patients
Safe Harbor Behavioral Care, LLC Social Worker CurrentSince Aug 1, 2022 Accepting new patients

Locations

1910 Towne Centre Blvd
Ste 250
Annapolis, MD 21401
Phone (202) 596-8891

1208 E Churchville Rd
Ste 300
Bel Air, MD 21014
Phone (410) 838-9500

2 Post Office Rd
Ste 1A
Waldorf, MD 20602

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1619411428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "534 CHISHOLM TRL",
            "city": "LUSBY",
            "state": "MD",
            "postal_code": "206573422",
            "telephone_number": "410-474-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783917",
            "telephone_number": "410-535-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODSON",
        "first_name": "KATHLEEN",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-13",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

Verify at the official NPI Registry.